手术去势与药物去势对前列腺癌患者心理及生活质量影响的比较  

Comparison of the effects of surgical and drug castration on the psychology and quality of life in patients with prostate cancer

作　　者：周小波[1] 叶志弘[1] 郭丹红[1] 朱双爱 蒋燕[1] 傅素靓[1] 张璟[1] 戚海琴[1] 刘娟[1] 

机构地区：[1]浙江大学医学院附属邵逸夫医院泌尿外科,浙江杭州310016

出　　处：《全科医学临床与教育》2015年第6期611-615,共5页Clinical Education of General Practice

基　　金：浙江省医药卫生科技计划项目(2011KYA091);国家自然科学基金资助项目(71373232)

摘　　要：目的研究手术去势和药物去势即雄激素阻断治疗对前列腺癌患者心理及生活质量的影响。方法采用症状自评量表(SCL-90)、癌症患者生命质量测定量表(QLQ-C30)及前列腺癌患者生活质量子量表(QLQ-PR25)对102例接受手术去势治疗和86例接受雄激素阻断治疗的前列腺癌患者,分别在治疗前、治疗后6个月及治疗后12个月的心理及生活质量状况进行评价。结果 SCL-90显示两种治疗方法组在治疗6月后和治疗12月后躯体化、强迫、人际关系、焦虑及精神病性方面均有改善(t分别=2.87、3.91、3.49、4.17、1.99、3.01、3.95、3.74、4.28、4.58;2.09、2.21、2.17、1.99、3.96、1.99、2.13、2.08、1.99、3.73,P均<0.05)。两种方法治疗6月后和治疗12月后都能缓解疼痛和改善排尿(t分别=3.76、4.51,3.51、4.58;2.41、4.37,2.53、4.63,P均<0.05),尤其对治疗6月后的性功能影响较明显(t分别=3.57、3.37,P均<0.05)。药物去势治疗对性功能有不同程度的改善,而手术治疗却造成永久性性功能丧失。结论两种治疗方案都带来不同程度的心理问题,使前列腺癌患者的生活质量下降,但药物去势对部分生活质量的影响是可逆的。Objective To study the effects of surgical castration and drug castration （androgen deprivation therapy） on the psychology and quality of life in patients with prostate cancer. Methods The symptom self rating scale （SCL-90）, QLQ-C30 scale and QLQ-PR25 sub scale were used to investigate 102 cases of prostate cancer who accepted surgical cas-tration and 86 cases of prostate cancer who received androgen deprivation therapy before treatment and after treatment for 6 months and 12 months. Results The SCL-90 survey showed that the somatization, compulsion, interpersonal relation-ships, anxiety and psychotic after treatment for 6 months and 12 months of patients treated with two different therapies were significantly improved （t=2.87, 3.91, 3.49, 4.17, 1.99, 3.01, 3.95, 3.74, 4.28, 4.58; 2.09, 2.21, 2.17, 1.99, 3.96, 1.99, 2.13, 2.08, 1.99, 3.73,P〈0.05）. The two treatments relieved pain and improved urination after treatment for 6 and 12 months （t=3.76,4.51,3.51,4.58; 2.41,4.37,2.53,4.63,P〈0.05）, especially improving sexual function after treatment for 6 months（t=3.57,3.37,P〈0.05）. The treatment of medical castration had different degrees of improvement on sexual function, and surgical treatment caused permanent loss of sexual function. Conclusion Two kinds of treatment programs bring different psychological problems so that lower the quality of life. But the effect of medical castration on the quality of life of the patients is reversible.

关 键 词：前列腺癌 手术治疗 药物去势 心理状况 生活质量 

分 类 号：R737.25[医药卫生—肿瘤]